Post-Gastrectomy Gastronomy

Share article

Nine months ago I had a total gastrectomy. During the first few days I had
much discomfort and distress because eating even a small amount led to both
colic and diarrhoea. Fortunately, this period passed as I learnt what to do
and as the disturbed reflexes that link the alimentary canal re-coordinated
themselves. This much they tell you at the hospital but they tell you very
little else.

Since there is more to say, I offer the suggestions and tips below in the
hope that
they may be of use and collected in an anthology of others' experiences -
which
may well be different. Finally I offer a tip which has, for me, resolved
most of the
problems.

The challenge is to eat enough to have some energy and avoid losing weight.
The problem is discomfort on eating. This comes in the form of pain where
the ileum is joined to the oesophagus, colic in the intestines and sudden
uncontrollable diarrhoea (known as 'hurry' and 'dumping'). There are ways
of
avoiding, or at least mitigating, these problems.

Although I was advised to sit upright after eating, the most comfortable
position seems to be to recline on a couch. Indeed, eating at the table is
the most uncomfortable position. 'Grazing' while walking about seems to
work
quite well but sitting at table definitely can be awkward. This is
compounded if you
have delayed eating and become tired when the eventual meal will be even
more
difficult to eat.

There is an assumption that invalids should be fed soup and gelatinous
porridge or gruel but both involve a lot of bulk for little nutrition.
Further, soup may not need chewing but actually the act of chewing is
beneficial and slows down the rate at which you ingest the food. Real food
is better -
although at first in very, very small portions - and pleasurable.

Generate confidence and successes for yourself by only taking small portions
onto your plate. Take only what you know you can eat. As any child will
tell you, food left on the plate becomes the subject of reproach whereas
taking a second helping is always a treat.

I asked my neighbours to bring me small plates of their 'left-overs'. This
variety of interesting dishes is fun and very convenient! Similarly, in the
restaurant, I ask for an extra plate and treat my friends' meals as my
buffet. Leave room for their puddings!

Certain foods do not suit you - but most are fine. I find unpleasant food
or
drink that is highly spiced or acidic. I no longer eat curries, pickles,
certain fruit and I forgo all wine. Fizzy drinks and cold drinks cause
discomfort so I avoid or warm them. But everything else is OK if I chew it
well and take it slowly. When the diarrhoea does strike, beware jumping to
conclusions and excluding a particular item from your diet on the basis of
just
one occasion. There is a lot of random luck involved.

I have a supply of snacks which I enjoy eating between meals and if I wake
in
the night. Custard tarts at 180 calories each, ginger biscuits at 35
calories and bananas are my delight. Vegetable juice goes with gin quite as
well as did the tonic water. On the other hand, the prescription foods fail
to please.

On hot days when I need to drink extra fluids, I add a little sugar to the
glass of water which makes it much easier to drink.

Since most of one's calories are used to keep one warm, if you wear extra
clothes you will not need to eat quite so much!

Sometimes colic does recur. It is painful and very unpleasant. Peppermint
oil is widely recommended and works very well. Place a few drops in a cup
of
boiling water, recline on a couch and slowly sniff and sip it.

I assume my absorption of nutriments is imperfect so I take the following
supplements: multi-minerals, extra magnesium, vitamin C, vitamin E, a B
complex vitamin pill and a quarterly B12 injection. I also take
acidophillus
and live yoghurt to boost my intestinal bacteria.

The most useful discovery was the value of uncooked porridge oats for
breakfast. Breakfast had been the most difficult meal. Now I have
discovered that 85 grams of porridge oats (best quality from a health food
shop), soaked overnight in full cream milk, sometimes with currents and
sunflower seeds, is easy to eat and remarkably effective for the whole day.

I eat it as I wander around making my early morning cup of tea. It provides
almost 500 calories which is a wonderfully significant part of my daily
requirement
and has eased the obligation to snack. But even more useful, it seems to
regulate
and stabilize the whole system which now feels quite robust: 'hurry',
'dumping'
colic and diarrhoea are no longer a problem. In fact, my difficulties
stemming
from the gastrectomy are largely resolved.